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患者,女,48岁,农民.10天前开始发热、头痛、咳嗽、流鼻涕、咽痛,经抗感冒、抗炎治疗,症状基本缓解.4天前出现左侧视物模糊并上眼睑下垂,晨轻暮重,左半侧头痛,隐痛,呈间歇性,
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患者,女,48岁,农民.10天前开始发热、头痛、咳嗽、流鼻涕、咽痛,经抗感冒、抗炎治疗,症状基本缓解.4天前出现左侧视物模糊并上眼睑下垂,晨轻暮重,左半侧头痛,隐痛,呈间歇性,无吞咽困难、饮水呛咳、言语含糊、意识丧失、四肢抽搐.既往无偏头痛史.入院查体:体温36.7℃,脉搏82次/分,呼吸19次/分,血压17/10 kPa;发育正常,营养中等,神志清楚,右侧瞳孔直径4 mm,光反射敏感,左上眼睑下垂,左侧瞳孔直径7 mm,光反射迟钝,双眼球各方向运动自如,眼底正常,浅表淋巴结未及,颈软,甲状腺不肿大,心肺腹部正常,四肢肌力、肌张力正常,生理反射存在,病理反射未引出,无脑膜刺激征.
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